INTRODUCTION The coronavirus disease 19 (COVID-19) pandemic disrupted endoscopy practices, creating unprecedented decreases in cancer screening and surveillance services. We aimed to assess the impact of the pandemic on the proportion of patients diagnosed with Barrett's esophagus (BE) and BE-related dysplasia and adherence to established quality indicators. METHODS Data from all esophagogastroduodenoscopies in the GI Quality Improvement Consortium, a national repository of matched endoscopy and pathology data, were analyzed from January 2018 to December 2022. Four cohorts were created based on procedure date and COVID-19 data: pre-pandemic (January 2018 to February 2020), pandemic-phase I (March 2020 to July 2020), pandemic-phase II (August 2020 to May 2021), and pandemic-phase III (June 2021 to December 2022). Observed and expected number of BE and BE-related dysplasia cases per month and adherence to the Seattle biopsy protocol and recommended surveillance intervals for nondysplastic BE (NDBE) were evaluated. RESULTS Among 2,446,857 esophagogastroduodenoscopies performed during the study period, 104,124 (4.3%) had pathology-confirmed BE. The histologic distribution was 87.4% NDBE, 1.8% low-grade dysplasia, 2.4% indefinite for dysplasia, and 1.4% high-grade dysplasia. The number of monthly BE (-47.9% pandemic-phase I, -21.5% pandemic-phase II, and -19.0% pandemic-phase III) and BE-related dysplasia (high-grade dysplasia: 41.2%, -27.7%, and -19.0%; low-grade dysplasia: 49.1%, -35.3%, and -26.5%; any dysplasia: 46.7%, -32.3%, and -27.9%) diagnoses were significantly reduced during the pandemic phases compared with pre-pandemic data. Adherence rates to the Seattle protocol and recommended surveillance intervals for NDBE did not decline during the pandemic. DISCUSSION There was a significant decline in the number of BE and BE-related dysplasia diagnoses during the COVID-19 pandemic, with an approximately 50% reduction in the number of cases of dysplasia diagnosed in the early pandemic. The absence of a compensatory increase in diagnoses in the pandemic-phase II and III periods may result in deleterious downstream effects on esophageal adenocarcinoma morbidity and mortality.

中文翻译：

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COVID-19 大流行期间巴雷特食管及相关发育不良的诊断显着减少。


简介 冠状病毒病 19 (COVID-19) 大流行扰乱了内窥镜检查实践，导致癌症筛查和监测服务空前减少。我们的目的是评估这一流行病对诊断为巴雷特食管 (BE) 和 BE 相关发育不良的患者比例以及遵守既定质量指标的影响。方法 对 2018 年 1 月至 2022 年 12 月期间来自 GI 质量改进联盟（一个匹配内窥镜检查和病理学数据的国家存储库）中所有食管胃十二指肠镜检查的数据进行了分析。根据手术日期和 COVID-19 数据创建了四个队列：大流行前（1 月） 2018年至2020年2月）、大流行第一阶段（2020年3月至2020年7月）、大流行第二阶段（2020年8月至2021年5月）和大流行第三阶段（2021年6月至2022年12月）。评估了每月观察到的和预期的 BE 和 BE 相关不典型增生病例数，以及对西雅图活检方案的遵守情况以及非不典型增生 BE (NDBE) 的推荐监测间隔。结果 在研究期间进行的 2,446,857 例食管胃十二指肠镜检查中，104,124 例 (4.3%) 患有病理证实的 BE。组织学分布为87.4% NDBE、1.8% 低度不典型增生、2.4% 不确定不典型增生和1.4% 高度不典型增生。每月 BE（-47.9% 大流行 I 期、-21.5% 大流行 II 期和 -19.0% 大流行 III 期）和 BE 相关不典型增生（高度不典型增生：41.2%、-27.7% 和与大流行前的数据相比，大流行期间的诊断显着减少：-19.0%；低度不典型增生：49.1%、-35.3%和-26.5%；任何不典型增生：46.7%、-32.3%和-27.9% 。在大流行期间，西雅图协议的遵守率和建议的 NDBE 监测间隔并未下降。 讨论 在 COVID-19 大流行期间，BE 和 BE 相关的不典型增生诊断数量显着下降，大流行早期诊断的不典型增生病例数减少了约 50%。大流行第二阶段和第三阶段诊断数量的补偿性增加可能会对食管腺癌发病率和死亡率产生有害的下游影响。